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I Overcomplicated Medicare Advantage (And Found a Simple Fix That Worked) — Fady Sahhar

Home Care Hindsight

Release Date: 07/01/2025

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Fady Sahhar, a disability advocate and home care strategist with decades of experience, unveils how Medicare Advantage is reshaping home care—and why agencies must rethink caregiver training to thrive.

In this eye-opening conversation with host David Knack, Fady shares:

  • Why 750+ Medicare Advantage plans now cover home care (and how to tap into this growing market).
  • The "lifetime value" mindset shift that turns clients into long-term partners.
  • How peer coaching solves EVV resistance and caregiver retention challenges.
  • Fady also reveals common cultural blindspots when expanding into new markets, the underrated power of back-office customer service, and why "nothing about us without us" should guide every disability interaction.

In This Episode, You’ll Discover:

  • Medicare Advantage 101: Reimbursement rates, local plan strategies, and why home care beats home health for post-discharge recovery.
  • The "Wheelchair Lesson": How to interact with clients with disabilities (hint: sit down first).
  • Rural vs. Urban Care: Why training must adapt to community rhythms—not just policies.
  • Peer Coaching Magic: How top caregivers can train teams better than supervisors.
  • Data = Negotiation Power: What payers really want from home care agencies in value-based contracts.

Lesson Takeaways:

  1. Medicare Advantage is a gateway. Reimbursement sits between Medicaid and private pay—but the real value is in lead generation and proving outcomes.
  2. Train caregivers as local experts. Your processes stay consistent, but training must reflect community needs.
  3. Peer coaches over policy manuals. Let star caregivers demonstrate EVV or crisis response—it’s 10x more effective.
  4. Track client health like a CRM. Preventing UTIs or hospitalizations is your leverage with payers.
  5. "Nothing about us without us." Involve clients with disabilities in designing their care.

Timestamps:

00:00 – Welcome to Home Care Hindsight

01:50 – Fady’s intro: Wheelchair user, quadri-lingual, and advocate

03:10 – How to interact with clients with disabilities (the "pull up a chair" rule)

05:25 – Medicare Advantage’s home care boom: 750+ plans and counting

08:30 – Why home care beats home health for post-discharge recovery

12:15 – Fady’s biggest mistake: Treating all clients as homogeneous

16:40 – Rural vs. urban care: Why training must adapt to local culture

20:50 – Peer coaching: How star caregivers can train teams (EVV success story)

25:30 – Underrated #1: Back-office customer service as a differentiator

29:45 – Underrated #2: Proving outcomes to payers (data = $$$)

33:20 – Little mistake: Ignoring client lifetime value (and how to fix it)

36:00 – Fady’s proudest win: Agencies embracing value-based care

38:10 – Final thoughts: Plugging The VBP Blog and Dual Eligible HQ

Quotes:

  1. "If you’re standing next to someone in a wheelchair, pull up a chair. Talk to them—not their companion." — Fady Sahhar

  2. "Medicare Advantage plans don’t need a nurse to help someone get dressed. They need a caregiver at half the cost." — Fady Sahhar

  3. "Peer coaches make EVV adoption feel like help—not surveillance." Fady Sahhar

  4. "Your caregivers are your eyes and ears. Train them to spot UTIs before ER visits happen." — Fady Sahhar

Resources:

  1. Connect with Fady Sahhar on LinkedIn: https://www.linkedin.com/in/fadysahhar/

  2. ProVantaCare Website: https://provantacare.com/

  3. The Value-Based Payment Blog: www.theVBPblog.com

  4. Dual Eligible HQ: www.DualEligibleHQ.com

  5. Connect with David Knack on LinkedIn: https://www.linkedin.com/in/david-knack/

  6. Connect with Zingage on LinkedIn: https://www.linkedin.com/company/zingage/

  7. Powered by Zingage: https://zingage.com/

  8. Watch Episode on Zingage’s YouTube: https://www.youtube.com/@Zingage